Osteoarthritis (OA) of the knee is a common condition that causes pain, inflammation, and stiffness in the knee joint. There are many types of treatments, ranging from heat or cold therapy, gentle movement and exercise, to medication and surgical options.

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Osteoarthritis is a condition that affects the cartilage in your joints. It’s the most common type of arthritis and affects some 32.5 million people in the United States.

The knee is one of the most common joints affected by osteoarthritis. Having this condition can make it difficult to walk, go up and down stairs, or perform other daily tasks.

This article will look at what causes osteoarthritis of the knee, how it’s treated, and what types of lifestyle changes may help improve your symptoms.

Osteoarthritis (OA) of the knee is caused by wear and tear to the knee joint. This means that the cartilage — the cushioning in the joint that allows the bones to glide over each other — breaks down over time with use.

As the cartilage breaks down, the bones in your knee begin to rub together and cause pain.

Risk factors for OA of the knee include:

  • Age: Wear and tear of the knee joint increases with age, particularly over the age of 50.
  • Sex: OA of the knee is more common in women than men.
  • Occupation: Jobs that require you to repeatedly put stress on your knee joint (i.e., frequent bending or lifting) put you at greater risk.
  • Injuries: Previous injuries to the knee joint may increase your risk.
  • Body weight: Excess body weight puts extra stress on the knee joint and may also lead to inflammation of the joint.
  • Genetics: People with a family history of knee OA may be more likely to develop it themselves.
  • Other health conditions: Certain metabolic diseases, bone irregularities, or other joint issues may increase the risk of knee OA.

Symptoms of OA may begin slowly and get worse with time.

You may experience:

  • stiffness after rest, like first thing in the morning
  • swelling of the knee joint
  • pain while in motion or at rest
  • range of motion changes, like trouble bending or straightening your knee
  • crepitus, which is a creaking or grating noise in the joint
  • joint instability — feeling like your knee might “give out” or buckle
  • knee locking or sticking when bent or straight
  • bowed knees

Make an appointment with your doctor if any of these symptoms are impacting your everyday life. Your doctor will check for any swelling, range of motion issues, joint instability, and other symptoms.

There is no cure for OA of the knee. The condition is progressive, meaning that it gets worse over time. That said, treatment options may help reduce pain, improve mobility, and boost your quality of life.

OA of the knee is usually diagnosed with a review of your medical history and a physical exam of your knee.

Nondrug treatments

Your doctor may suggest trying non-medication options to help ease your symptoms before considering drugs or surgery.

These options include:

  • Ice or cold therapy can reduce blood flow to the area and ease pain and swelling.
  • Heat therapy improves circulation and may help lessen pain and stiffness.
  • Physical therapy may help strengthen the muscles around the knees and improve the range of motion and flexibility of the joint.
  • Alternative therapies like acupuncture or massage can stimulate blood flow and provide additional pain relief.
  • Topical creams that contain menthol, camphor, capsaicin, or CBD, may help ease inflammation and pain.
  • Weight loss may lighten the load on the knee joint and reduce pain, swelling, or stiffness.
  • Gentle exercises and movement may help improve blood flow and joint mobility.
  • Tai chi has been shown to help with improved balanced and a decreased risk of falls.
  • Devices like canes and braces can help you move around more easily.

Medication

There are several medications that may help ease the discomfort of knee OA. Your doctor will determine which medications may work best for you based on your symptoms, health history, and the presence of any other health conditions.

Medications may include:

  • Hyaluronic acid (HA) injections: This gel is injected directly into the knee joint to relieve pain and is a popular noninvasive alternative to surgical treatments.
  • Over-the-counter (OTC) pain medications: These drugs relieve pain and reduce inflammation. They include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen.
  • Topical medications: NSAIDs are also available as gels that can be applied directly to the knee joint for pain relief.
  • Prescription pain medications: Your doctor may prescribe COX-2 inhibitors like celecoxib and meloxicam if OTC medications aren’t effective.
  • Corticosteroids: Cortisone shots can be injected directly into the knee joint for pain relief and reduction of inflammation. You may be limited to four shots per year to limit the side effects.

Surgery

If other treatment options don’t work well, surgery may be recommended.

Surgical options include:

  • Cartilage restoration: Also called cartilage grafting, healthy cartilage from another joint is used to fill in the portion that has worn away. It’s most effective for younger people who have minimal damage.
  • Osteotomy: A portion of the shinbone or thighbone may be reshaped to reduce pressure on the knee joint. This surgery is best for people with early OA in just one side of the joint.
  • Knee replacement: Options for knee replacement include a total replacement or partial replacement. Your doctor will remove the damaged areas of the joint and replace it with a new joint comprised of metal or plastic.

While it may seem counterintuitive to walk or exercise when your knee feels stiff or swollen, walking and other low impact activities can be especially helpful for OA of the knee.

In fact, according to a 2022 study of people over age 50 with OA of the knee, walking and exercise led to less frequent bouts of knee pain. Walking may even be “disease-modifying,” which means it may slow a person’s symptoms from progressing.

In addition to walking, the following activities may help with OA:

  • swimming
  • aqua aerobics
  • cycling
  • light gardening

Along with getting the right treatment and therapies to help with your knee OA, there are lifestyle changes that may ease your symptoms, such as:

  • Avoiding triggers: Try to avoid movements that may flare your knee OA, such as kneeling, squatting, lifting, or walking up stairs.
  • Moving regularly: As already mentioned, movement can help with OA. Try low impact activities like gentle walking or swimming that don’t put a lot of stress on the knee joint. Yoga and balance training may also help build strength and improve your mind-body connection.
  • Losing weight: Losing excess weight may help reduce stress on the knee joint, ease pain, and improve overall joint function.
  • Considering cognitive behavioral therapy: The Arthritis Foundation recommends cognitive behavioral therapy (CBT) for people living with knee OA. CBT can help with setting attainable exercise goals, problem-solving, and overall positive thinking.

Osteoarthritis of the knee is a common condition that’s caused by cartilage that breaks down between the joints of the knee.

This can cause the bones of the knee joint to rub together, causing pain, inflammation, and stiffness. It’s more common as you age if you carry excess weight or if you do repetitive movements like bending, squatting, or lifting.

While there are many treatment options for knee OA, including conservative at-home therapies, medication, and surgery, what works for each person will be unique. It may take some trial and error to find what works best for you.